AS05.b. Tropical/parasite infections & travel medicine

PD017 - IMPORTED CHILDHOOD MALARIA IN LONDON: A RETROSPECTIVE ANALYSIS OF CLINICAL AUDIT DATA FROM NINE NHS HOSPITALS (2019-2020) (ID 536)

Session Name
0773 - Virtual Poster Discussion Session (ID 129)
Presenter
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e-Poster Audio MP3

Abstract

Backgrounds:

Background

Malaria is a tropical mosquito-borne infection caused by Plasmodium parasites. Prompt diagnosis and treatment are essential to prevent development of severe disease and death. The UK is estimated to have the most imported malaria cases of any non-endemic country, other than France. In 2010-2019 in the UK, there were on average >1600 reported cases per year (about 10% in children)

Methods

Methods

A retrospective clinical audit was undertaken at nine London NHS hospitals (2019-2020). Patients with a positive blood film were included; those transferred from external hospitals were excluded. The primary outcome was time from presentation to first antimalarial dose. Secondary outcomes included reasons for treatment delay and degree of compliance with local guidelines. Comparisons were made between children (0-15 years) and adults (≥16 years).

Results:

Results

Only 17/215 patients were children, of whom three had severe malaria, and none died (Table 1). Median time from presentation to first antimalarial dose was 7.7 and 6.2 hours in children and adults respectively (p=0.347). Median time from presentation to malaria screen request was 2.0 and 0.8 hours in children and adults respectively (p<0.001). Reported reasons for treatment delay in children included awaiting transfer to ward, patient discharged before blood film reported, and awaiting antimalarial medicines from pharmacy.

table 1.png

Conclusions/Learning Points:

Discussion

Median time from presentation to malaria screen request was 1.2 hours longer for children as compared to adults. However, there was no statistical difference in time from presentation to first antimalarial dose (possibly due to missing data for adults managed as outpatients). Some treatment delays in children may be prevented by starting antimalarial therapy before transfer to the ward, keeping the child in hospital until blood film is reported, and ensuring accessibility of antimalarial medication.

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PD016 - SEVERE MALARIA IN A CHILD COMPLICATED BY SECONDARY HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS (ID 1207)

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